If the enrolment of membership to medical schemes has been stagnant and the proportion of the population that enjoys cover has decreased during the past decade, why is the regulator discontinuing the low-cost benefit option intended to increase the affordability of medical schemes? Illustration: KAREN MOOLMANIf the enrolment of membership to medical schemes has been stagnant and the proportion of the population that enjoys cover has decreased during the past decade, why is the regulator...
Mainly, such products potentially use the state as a designated service provider without entering into agreements with the state, and lack prescribed minimum benefits. Prescribed minimum benefits are a set of defined benefits that ensures all medical scheme members have access to certain minimum health services, regardless of their benefit option.
Earlier in 2019 we received the following inputs from industry stakeholders on the benefits of low-cost benefit options: Experience in middle-income countries shows that extensions for health cover succeed when they target wealthier population members. The non-health expenditures in medical schemes are 8.4% of the contributions on average, compared with the 48.4% of the exempted insurers. This clearly indicates that a higher proportion of the member’s contributions fund administration costs than in a medical scheme.
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